Protocol For Examination Of Bone Tumor Specimens



Protocol For Examination Of Bone Tumor Specimens


G. Petur Nielsen, MD

Andrew E. Rosenberg, MD
















































































































































































Bone: Biopsy


Surgical Pathology Cancer Case Summary (Checklist)


Specimen



Specify bone involved (if known): ______________________________



____ Not specified


Procedure



____ Core needle biopsy



____ Curettage



____ Excisional biopsy



____ Other (specify): ______________________________



____ Not specified


Tumor Site (select all that apply)



____ Epiphysis or apophysis



____ Metaphysis



____ Diaphysis



____ Cortex



____ Medullary cavity



____ Surface



____ Tumor involves joint



____ Tumor extension into soft tissue



____ Cannot be determined


Tumor Size



Greatest dimension: __________ cm



*Additional dimensions: __________ x __________ cm



____ Cannot be determined


Histologic Type (World Health Organization [WHO] classification of bone tumors)



Specify: ______________________________



____ Cannot be determined


*Mitotic Rate



*Specify: __________ /10 high-power fields (HPF)



(1 HPF x 400 = 0.1734 mm2; X40 objective; most proliferative area)


Necrosis



____ Not identified



____ Present





Extent: __________ %



____ Cannot be determined


Histologic Grade



Specify: __________



____ Cannot be determined


*Lymph-Vascular Invasion



*____ Not identified



*____ Present



*____ Indeterminate


*Additional Pathologic Findings



*Specify: ______________________________


Ancillary Studies (required only if applicable)



Immunohistochemistry




Specify: ______________________________




____ Not performed



Cytogenetics




Specify: ______________________________




____ Not performed



Molecular pathology




Specify: ______________________________




____ Not performed


Radiographic Findings (if available)



Specify: ______________________________




____ Not available


* Data elements with asterisks are not required. These elements may be clinically important, but they are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens From Patients With Tumors of Bone.” Web posting date June 2012, www.cap.org.





























































































































































































































































































































































Bone: Resection


Surgical Pathology Cancer Case Summary (Checklist)


Specimen



Specify bone involved (if known): ______________________________



____ Not specified


Procedure



____ Intralesional resection



____ Marginal resection



____ Segmental/wide resection



____ Radical resection



____ Other (specify): ______________________________



____ Not specified


Tumor Site (select all that apply)



____ Epiphysis or apophysis



____ Metaphysis



____ Diaphysis



____ Cortical



____ Medullary cavity



____ Surface



____ Tumor involves joint



____ Tumor extension into soft tissue



____ Cannot be determined


Tumor Size



Greatest dimension: __________ cm



*Additional dimensions: __________ x __________ cm



____ Cannot be determined



____ Multifocal tumor/discontinuous tumor at primary site (skip metastasis)


Histologic Type (World Health Organization [WHO] classification of bone tumors)



Specify: ______________________________



____ Cannot be determined


*Mitotic Rate



*Specify: __________ /10 high-power fields



(1 HPF x 400 = 0.1734 mm2; X40 objective; most proliferative area)


Necrosis (macroscopic or microscopic)



____ Not identified



____ Present





Extent: __________ %


Histologic Grade



Specify: ______________________________



____ Not applicable



____ Cannot be determined


Margins



____ Cannot be assessed



____ Margins uninvolved by sarcoma





Distance of sarcoma from closest margin: __________ cm





Specify margin (if known): ______________________________



____ Margin(s) involved by sarcoma





Specify margin(s) if known: ______________________________


*Lymph-Vascular Invasion



*____ Not identified



*____ Present



*____ Indeterminate


Pathologic Staging (pTNM)



TNM descriptors (required only if applicable) (select all that apply)




____ m (multiple)




____ r (recurrent)




____ y (post-treatment)



Primary tumor (pT)




____ pTX: Primary tumor cannot be assessed




____ pT0: No evidence of primary tumor




____ pT1: Tumor ≤ 8 cm in greatest dimension




____ pT2: Tumor > 8 cm in greatest dimension




____ pT3: Discontinuous tumors in the primary bone site (not including skip metastasis)



Regional lymph nodes (pN)




____ pNX: Regional lymph nodes cannot be assessed




____ pN0: No regional lymph node metastasis




____ pN1: Regional lymph node metastasis




____ No nodes submitted or found




Number of lymph nodes examined





Specify: __________





Number cannot be determined (explain): ______________________________




Number of lymph nodes involved





Specify: __________





Number cannot be determined (explain): ______________________________



Distant metastasis (pM)




____ Not applicable




____ pM1a: Lung




____ pM1b: Metastasis involving distant sites other than lung (including skip metastases)





*Specify site(s), if known: ______________________________


*Additional Pathologic Findings



Specify: ______________________________


Ancillary Studies (required only if applicable)



Immunohistochemistry




Specify: ______________________________




____ Not performed



Cytogenetics




Specify: ______________________________




____ Not performed



Molecular pathology




Specify: ______________________________




____ Not performed


Radiographic Findings (if available)



Specify: ______________________________



____ Not available


Preresection Treatment (select all that apply)



____ No therapy



____ Chemotherapy performed



____ Radiation therapy performed



____ Therapy performed, type not specified



____ Unknown


Treatment Effect (select all that apply)



____ Not identified



____ Present





*Specify percentage of necrotic tumor: __________ %



____ Cannot be determined


* Data elements with asterisks are not required. These elements may be clinically important, but they are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens From Patients With Tumors of Bone.” Web posting date June 2012, www.cap.org.

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Jul 6, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Protocol For Examination Of Bone Tumor Specimens
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